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Viveros-Carreño D, Mora-Soto N, Rodríguez J, Rauh-Hain JA, Ramírez PT, Varón ML, Krause KJ, Grillo-Ardila CF, Jeronimo J, Pareja R. Recurrence After Biopsy-Confirmed Cervical High-Grade Intraepithelial Lesion Followed by Negative Conization: A Systematic Review and Meta-analysis. J Low Genit Tract Dis 2024; 28:26-31. [PMID: 37924263 PMCID: PMC10840981 DOI: 10.1097/lgt.0000000000000779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2023]
Abstract
ABSTRACT The aim of the study is to assess the recurrence rate (as cervical intraepithelial neoplasia 2+ [CIN2+]) in patients who had a confirmed high-grade squamous intraepithelial lesion (CIN2-3) in a cervical biopsy specimen followed by a negative conization specimen. MATERIALS AND METHODS A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Ovid/MEDLINE, Ovid/Embase, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched from inception until January 2023. The study protocol was registered in PROSPERO (ID number CRD42023393951). The search identified 3,089 articles; 1,530 were removed as duplicates, and 1,559 titles and abstracts were assessed for inclusion. The full text of 26 studies was assessed for eligibility, and finally, 12 studies with 1,036 patients were included. All included studies were retrospective cohort studies. A proportion meta-analysis was performed. RESULTS For patients with negative conization specimens, the recurrence rate as CIN2+ during follow-up was 6% (95% CI, 1.8%-12.1%; I2 = 49.2; p < .0001, 215 patients and 4 studies) in the proportion meta-analysis, ranging from 0.3% to 13.0% for the individual studies. For patients with ≤CIN1 conization specimens, the recurrence rate as CIN2+ during follow-up was 3.6% (95% CI, 1.2%-7%; I2 = 75.1; p < .0001, 991 patients and 10 studies) in the proportion meta-analysis and ranged from 0.6% to 13.0% for the individual studies. CONCLUSIONS The recurrence rate as CIN2+ for patients with a confirmed high-grade intraepithelial lesion on a cervical biopsy followed by a negative conization specimen is 6%. In patients with negative and CIN1 conization specimens, the recurrence rate is 3.6%.
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Affiliation(s)
- David Viveros-Carreño
- Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia
- Department of Gynecologic Oncology, Clínica Universitaria Colombia and Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo – CTIC. Bogotá, Colombia
| | - Nathalia Mora-Soto
- Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Juliana Rodríguez
- Grupo de Investigación Clínica y Epidemiológica del Cáncer - GICEC, Instituto Nacional de Cancerología, Bogotá, Colombia
- Department of Obstetrics and Gynecology, Universidad Nacional de Colombia, Bogotá, Colombia
- Departamento de Ginecología, Obstetricia y Reproducción Humana, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - José Alejandro Rauh-Hain
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Pedro T. Ramírez
- Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas, USA
| | - Melissa López Varón
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kate J. Krause
- Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | | | - René Pareja
- Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia
- Department of Gynecologic Oncology, Clínica ASTORGA, Medellín, Colombia
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Agustí N, Viveros-Carreño D, Mora-Soto N, Ramírez PT, Rauh-Hain A, Wu CF, Rodríguez J, Grillo-Ardila CF, Salazar C, Jorgensen K, Segarra-Vidal B, Chacón E, Melamed A, Pareja R. Diagnostic accuracy of sentinel lymph node frozen section analysis in patients with early-stage cervical cancer: A systematic review and meta-analysis. Gynecol Oncol 2023; 177:157-164. [PMID: 37703622 DOI: 10.1016/j.ygyno.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE To assess the diagnostic accuracy of intraoperative SLN frozen section analysis compared with ultrastaging in patients with early-stage cervical cancer. METHODS A systematic literature review was conducted following the PRISMA checklist. MEDLINE (via Ovid), Embase, and the Cochrane Central Register of Controlled Trials were searched from inception until February 2023. The inclusion criteria were patients with early-stage cervical cancer (2018 FIGO stage I-II), consisting of the histological subtype squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma (≥90% of the patients in each study), who underwent SLN detection (with any tracer) and intraoperative frozen section followed by SLN ultrastaging. Randomized controlled trials, prospective and retrospective observational studies were considered. The detection rates and measures of diagnostic accuracy were pooled using a random effects univariate model. A preplanned subgroup meta-analysis was conducted, with isolated tumor cells excluded as positive lymph nodes. The review was registered in PROSPERO (CRD42023397147). RESULTS The search identified 190 articles, with 153 studies considered potentially eligible after removing duplicates. Fourteen studies met the selection criteria, including a total of 1720 patients. Seven studies were retrospective, and the other seven were prospective. Frozen section analysis detected 159 of 292 (54.5%) patients with lymph node metastases. In 281 patients the type of volume metastasis was reported: 1 of 41 (2.4%) patients had isolated tumor cells, 21 of 78 (26.9%) patients had micrometastases, and 133 of 162 (82.1%) patients had macrometastases. The pooled sensitivity of intraoperative SLN frozen section analysis was 65% (95% CI, 51-77%) for macrometastases, micrometastases, and isolated tumor cells. When we excluded patients with isolated tumor cells, the pooled sensitivity increased to 72% (95% CI, 60-82%). CONCLUSION SLN frozen section detects 65% of lymph node metastases compared with SLN ultrastaging and may prevent unnecessary radical surgery in some patients with early-stage cervical cancer.
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Affiliation(s)
- Nuria Agustí
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
| | - David Viveros-Carreño
- Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia; Department of Gynecologic Oncology, Clínica Universitaria Colombia and Centro de Tratamiento (e) Investigación sobre Cáncer Luis Carlos Sarmiento Angulo - CTIC, Bogotá, Colombia
| | - Nathalia Mora-Soto
- Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Pedro T Ramírez
- Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, TX, United States of America
| | - Alejandro Rauh-Hain
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Chi-Fang Wu
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Juliana Rodríguez
- Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia; Department of Gynecology and Obstetrics, Section of Gynecologic Oncology, Fundación Santa Fe de Bogotá, Bogotá, Colombia; Department of Obstetrics and Gynecology, Universidad Nacional de Colombia, Bogotá, Colombia
| | | | - Catherin Salazar
- Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Kirsten Jorgensen
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Blanca Segarra-Vidal
- Department of Obstetrics and Gynaecology, University General Hospital of Castellon, Castellon, Spain
| | - Enrique Chacón
- Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Alexander Melamed
- Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America; New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States of America; Herbert Irving Comprehensive Cancer Center, New York, NY, United States of America
| | - René Pareja
- Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia; Department of Gynecologic Oncology, Clínica ASTORGA, Medellín, Colombia
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Mazarico-Altisent I, Capel I, Baena N, Bella-Cueto MR, Barcons S, Guirao X, Albert L, Cano A, Pareja R, Caixàs A, Rigla M. Novel germline variants of CDKN1B and CDKN2C identified during screening for familial primary hyperparathyroidism. J Endocrinol Invest 2023; 46:829-840. [PMID: 36334246 PMCID: PMC10023768 DOI: 10.1007/s40618-022-01948-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE CDKN1B mutations were established as a cause of multiple endocrine neoplasia 4 (MEN4) syndrome in patients with MEN1 phenotype without a mutation in the MEN1 gene. In addition, variants in other cyclin-dependent kinase inhibitors (CDKIs) were found in some MEN1-like cases without the MEN1 mutation. We aimed to describe novel germline mutations of these genes in patients with primary hyperparathyroidism (PHPT). METHODS During genetic screening for familial hyperparathyroidism, three novel CDKIs germline mutations in three unrelated cases between January 2019 and November 2021 were identified. In this report, we describe clinical features, DNA sequence analysis, and familial segregation studies based on these patients and their relatives. Genome-wide DNA study of loss of heterozygosity (LOH), copy number variation (CNV), and p27/kip immunohistochemistry was performed on tumour samples. RESULTS DNA screening was performed for atypical parathyroid adenomas in cases 1 and 2 and for cystic parathyroid adenoma and young age at diagnosis of PHPT in case 3. Genetic analysis identified likely pathogenic variants of CDKN1B in cases 1 and 2 and a variant of the uncertain significance of CDKN2C, with uniparental disomy in the tumour sample, in case 3. Neoplasm screening of probands showed other non-endocrine tumours in case 1 (colon adenoma with dysplasia and atypical lipomas) and case 2 (aberrant T-cell population) and a non-functional pituitary adenoma in case 3. CONCLUSION Germline mutations in CDKIs should be included in gene panels for genetic testing of primary hyperparathyroidism. New germline variants here described can be added to the current knowledge.
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Affiliation(s)
- I Mazarico-Altisent
- Endocrinology and Nutrition Department, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain.
| | - I Capel
- Endocrinology and Nutrition Department, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - N Baena
- Genetic Department, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - M R Bella-Cueto
- Pathology Department, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - S Barcons
- Surgery Department, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - X Guirao
- Surgery Department, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - L Albert
- Endocrinology and Nutrition Department, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - A Cano
- Endocrinology and Nutrition Department, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - R Pareja
- Endocrinology and Nutrition Department, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - A Caixàs
- Endocrinology and Nutrition Department, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - M Rigla
- Endocrinology and Nutrition Department, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí (I3PT), Medicine Department, Universitat Autònoma de Barcelona, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
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Leme A, Fisberg R, Haines J, Ferrari G, Veroneze Melo A, Gomez G, Hermes Sales C, Kovalskys I, Herrera-Cuenca M, Cortés Sanabria L, Yépez García M, Pareja R, Rigotti A, Fisberg M. Prevalence of Inadequacy and Food Sources of Shortfall Nutrients in Latin Americans: ELANS Study. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Alméciga A, Rodriguez J, Beltrán J, Sáenz J, Merchán A, Egurrola J, Burbano J, Trujillo L, Heredia F, Pareja R. Emergency Embolization of Pelvic Vessels in Patients With Locally Advanced Cervical Cancer and Massive Vaginal Bleeding: A Case Series in a Latin American Oncological Center. JCO Glob Oncol 2021; 6:1376-1383. [PMID: 32903119 PMCID: PMC7529508 DOI: 10.1200/go.20.00239] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Locally advanced cervical cancer may present with uncontrollable vaginal bleeding in up to 70% of cases. Pelvic vessel embolization has been used as an urgent maneuver for achieving fast hemostatic control. This report describes outcomes of selective pelvic vessel embolization in patients with severe bleeding due to a locally advanced cervical cancer. METHODS In this retrospective study, technical aspects, clinical variables, and bleeding-related morbidity were described. The frequency of recurrent disease and the vital status at 1 year of follow-up were determined. Analysis was performed with statistical software R, version 3.6.2. The setting was Instituto Nacional de Cancerología- Bogotá, Colombia, between January 2009 and July 2017. RESULTS A total of 47 patients were included. Median age was 44 years (range, 26-70 years). The pre-embolization median hemoglobin level was 7.9 g/dL (range, 5.0-11.3 g/dL). Blood transfusions were administered to 41 women (87.2%). Bleeding control was achieved in 95.7% of cases in the first 24 hours after the embolization. There were no major complications. In 17 cases (36.2%), minor complications were reported; the most common was pelvic pain. In 17.1% of cases, a second embolization was required. After 12 months of follow-up, 27.7% of patients were alive without disease, 44.7% were alive with disease, and 25.5% of them have died of cervical cancer progression. CONCLUSION Selective pelvic vessel embolization is a useful alternative in patients with locally advanced cervical cancer and life-threatening bleeding. Its impact on recurrent disease and death due to oncologic cause is not clear.
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Affiliation(s)
- Adriana Alméciga
- Department of Gynecology Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Juliana Rodriguez
- Department of Gynecology Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia.,Department of Gynecology and Obstetrics, Section of Gynecology Oncology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Julián Beltrán
- Department of Radiology, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - James Sáenz
- Department of Gynecology Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia.,Universidad Militar Nueva Granada, Bogotá, Colombia
| | - Abel Merchán
- Centro de Investigaciones Oncológicas Clínica San Diego, Bogotá, Colombia
| | - Jorge Egurrola
- Faculty of Health Science, Program of Medicine, Universidad de Magdalena, Magdalena, Colombia
| | | | - Lina Trujillo
- Department of Gynecology Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Fernando Heredia
- Department of Gynecology and Obstetrics, School of Medicine, Universidad de Concepción, Concepción, Chile
| | - René Pareja
- Department of Gynecology Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia.,Clínica de Oncología Astorga, Corporación Universitaria Remington, Universidad Pontificia Bolivariana, Medellín, Colombia
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Lopez A, Rodriguez J, Estrada E, Aragona A, Chavez C, Amaro K, De Padua C, Borges Garnica A, Rendón G, Alméciga A, Serrano O, Scasso S, Laufer J, Greif D, Taranto F, Hoegl J, Calderaro di Ruggiero F, Pareja R. Neoadjuvant chemotherapy in pregnant patients with cervical cancer: a Latin-American multicenter study. Int J Gynecol Cancer 2021; 31:468-474. [PMID: 33649015 DOI: 10.1136/ijgc-2020-001764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To describe oncologic and obstetric outcomes in patients diagnosed with cervical cancer during pregnancy who had a successful delivery after neoadjuvant chemotherapy. METHODS A multicenter retrospective review was conducted in 12 institutions from six Latin American countries, between January 2007 and December 2018. Data collected included clinical characteristics, neoadjuvant chemotherapy agents, treatment, obstetric and oncologic outcomes. RESULTS Thirty-three patients were included. Median age was 34 years (range 31-36). Twenty (60.6%) women were diagnosed at early stage (IB), and 13 (39.4%) with locally advanced stage (IIA-IIIB) according to FIGO 2009 classification. Carboplatin and paclitaxel was the most frequent combination used (60.6%). Partial and complete response rates were 27.3% and 9.1%, respectively. Median gestational age at delivery was 35 weeks (range 34-36). All patients had live births delivered by cesarean section. Obstetric pathology: pre-term labor, placenta percreta or intra-uterine growth restriction, was documented in seven patients (21.2%). Two (6.1%) neonates had low birth weight. Definitive treatment was primary chemo-radiation in 19 (57.6%) patients, radical hysterectomy in 11 (33.3%), abandoned radical hysterectomy with para-aortic lymphadenectomy and ovarian transposition in 1 patient (3.0%), and no further treatment in 2 (6.1%) patients. After a median follow-up of 16.3 months (range 2.0-36.9), 8 (26.7%) patients had recurrent disease. Of these, four (13.3%) died due to disease. CONCLUSION Neoadjuvant chemotherapy may be offered to patients wishing to preserve an ongoing pregnancy in order to achieve fetal maturity. Long-term consequences of chemotherapy in the child are yet to be determined.
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Affiliation(s)
- Aldo Lopez
- Department of Gynecologic Surgery, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Juliana Rodriguez
- Department of Gynecology Oncology, Instituto Nacional de Cancerologia, Bogota, Colombia.,Department of Gynecology and Obstetrics. Section of Gynecologic Oncology, Fundacion Santa Fe de Bogota, Bogota, Colombia
| | - Erick Estrada
- Department of Gynecology and Obstetrics, Hospital General San Juan de Dios, Guatemala City, Guatemala, Guatemala
| | - Alejandro Aragona
- Hospital Municipal de Oncologia Marie Curie, Buenos Aires, Federal District, Argentina
| | - Carlos Chavez
- Instituto Regional de Enfermedades Neoplásicas (IREN Sur), Arequipa, Peru
| | - Karina Amaro
- Hospital Nacional Cayetano Heredia, Lima, Lima, Peru
| | | | - Alfredo Borges Garnica
- Unidad de Terapia Antineoplásica (UTAN), Centro Médico Guerra Méndez, Valencia, Venezuela, Bolivarian Republic
| | - Gabriel Rendón
- Department of Gynecologic Oncology, Instituto de Cancerología- Las Américas-AUNA, Medellin, Antioquia, Colombia
| | - Adriana Alméciga
- Department of Gynecology Oncology, Instituto Nacional de Cancerologia, Bogota, Colombia
| | - Oscar Serrano
- Department of Gynecologic Oncology, Hospital Militar Centra, Bogotá, Colombia
| | - Santiago Scasso
- Department of Gynecologic Oncology, Hospital Pereira Rossell, Montevideo, Uruguay
| | - Joel Laufer
- Department of Gynecologic Oncology, Hospital Pereira Rossell, Montevideo, Uruguay
| | - Diego Greif
- Department of Gynecology, Hospital de Clínicas Dr. Manuel Quintela, Universidad de la República, Montevideo, Uruguay
| | - Fernando Taranto
- Department of Gynecology, Hospital de Clínicas Dr. Manuel Quintela, Universidad de la República, Montevideo, Uruguay
| | - Jorge Hoegl
- Servicio Oncológico Hospitalario del Instituto Venezolano de los Seguros Sociales, Caracas, Venezuela
| | | | - René Pareja
- Department of Gynecology Oncology, Instituto Nacional de Cancerologia, Bogota, Colombia .,Clínica de Oncología Astorga, Universidad Pontificia Bolivariana, Medellin, Colombia
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Casamitjana L, Giménez-Palop O, Corripio R, Pareja R, Berlanga E, Rigla M, Oliva JC, Caixàs A. Glucagon stimulation test to assess growth hormone status in Prader-Willi syndrome. J Endocrinol Invest 2021; 44:621-629. [PMID: 32720093 PMCID: PMC7878226 DOI: 10.1007/s40618-020-01367-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/16/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Growth hormone deficiency (GHD) must be confirmed before starting treatment in adults with Prader-Willi syndrome (PWS). Most studies use the growth-hormone-releasing hormone plus arginine (GHRH-arginine) test. No data are available on the glucagon stimulation test (GST) in PWS. We compared the utility of fixed-dose (1 mg) GST versus GHRH-arginine test in diagnosing GHD. METHODS Adults and late adolescents with PWS underwent both tests on separate days. In the GHRH-arginine test, GHD was defined according to body mass index. In the GST, two cutoffs were analyzed: peak GH concentration < 3 ng/mL and < 1 ng/mL. For analyses, patients were divided into two groups according to body weight (≤ 90 kg and > 90 kg). RESULTS We analyzed 34 patients: 22 weighing ≤ 90 kg and 12 weighing > 90 kg. In patients weighing ≤ 90 kg, the two tests were concordant in 16 (72.72%) patients (k = 0.476, p = 0.009 with GST cutoff < 3 ng/mL, and k = 0.450, p = 0.035 with GST cutoff < 1 ng/mL). In patients weighing > 90 kg, the two tests were not concordant with GST cutoff < 3 ng/mL, but were concordant in 11 (91.6%) patients (k = 0.833, p = 0.003) with GST cutoff < 1 ng/mL. GH peaks on the two tests correlated (r = 0.725, p = 0.008). CONCLUSION Fixed-dose (1 mg) GST using a peak GH cutoff of < 3 ng/mL or < 1 ng/mL promises to be useful for screening for GHD in adults and late adolescents with PWS. However, in those weighing > 90 kg, the < 1 ng/mL cutoff seems better. Larger studies are necessary to establish definitive glucagon doses and cutoffs, especially in extremely obese patients.
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Affiliation(s)
- L Casamitjana
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, C/ Parc Taulí, 1, 08208, Sabadell, Spain
- Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - O Giménez-Palop
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, C/ Parc Taulí, 1, 08208, Sabadell, Spain
- Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - R Corripio
- Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- Pediatrics Department, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - R Pareja
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, C/ Parc Taulí, 1, 08208, Sabadell, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - E Berlanga
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- Clinical Laboratory Department, UDIAT, Corporació Sanitària Universitària Parc Taulí, Sabadell, Spain
| | - M Rigla
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, C/ Parc Taulí, 1, 08208, Sabadell, Spain
- Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - J C Oliva
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- Epidemiology Department, Fundació Parc Taulí, Sabadell, Spain
| | - A Caixàs
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, C/ Parc Taulí, 1, 08208, Sabadell, Spain.
- Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain.
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain.
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Ramirez P, Frumovitz M, Pareja R, Lopez A, Vieira M, Ribeiro R. Phase III randomized trial of laparoscopic or robotic versus abdominal radical hysterectomy in patients with early-stage cervical cancer: LACC Trial. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.552] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Carro G, Muñoz A, Monge M, Savoini B, Galatanu A, Galatanu M, Pareja R. Thermal conductivity and diffusivity of Cu-Y alloys produced by different powder metallurgy routes. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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del Campo R, Savoini B, Muñoz A, Monge M, Pareja R. Processing and mechanical characteristics of magnesium-hydroxyapatite metal matrix biocomposites. J Mech Behav Biomed Mater 2017; 69:135-143. [DOI: 10.1016/j.jmbbm.2016.12.023] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 12/22/2016] [Accepted: 12/23/2016] [Indexed: 11/29/2022]
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Barquet-Muñoz SA, Rendón-Pereira GJ, Acuña-González D, Peñate MVH, Herrera-Montalvo LA, Gallardo-Alvarado LN, Cantú-de León DF, Pareja R. Role of pelvic and para-aortic lymphadenectomy in abandoned radical hysterectomy in cervical cancer. World J Surg Oncol 2017; 15:23. [PMID: 28088221 PMCID: PMC5237563 DOI: 10.1186/s12957-016-1067-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 12/14/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cervical cancer (CC) occupies fourth place in cancer incidence and mortality worldwide in women, with 560,505 new cases and 284,923 deaths per year. Approximately, nine of every ten (87%) take place in developing countries. When a macroscopic nodal involvement is discovered during a radical hysterectomy (RH), there is controversy in the literature between resect macroscopic lymph node compromise or abandonment of the surgery and sending the patient for standard chemo-radiotherapy treatment. The objective of this study is to compare the prognosis of patients with CC whom RH was abandoned and bilateral pelvic lymphadenectomy and para-aortic lymphadenectomy was performed with that of patients who were only biopsied or with removal of a suspicious lymph node, treated with concomitant radiotherapy/chemotherapy in the standard manner. METHODS A descriptive and retrospective study was conducted in two institutions from Mexico and Colombia. Clinical records of patients with early-stage CC programmed for RH with an intraoperative finding of pelvic lymph, para-aortic nodes, or any extracervical involvement that contraindicates the continuation of surgery were obtained. Between January 2007 and December 2012, 42 clinical patients complied with study inclusion criteria and were selected for analysis. RESULTS In patients with CC whom RH was abandoned due to lymph node affectation, there is no difference in overall survival or in disease-free period between systematic lymphadenectomy and tumor removal or lymph node biopsy, in pelvic lymph nodes as well as in para-aortic lymph nodes, when these patients receive adjuvant treatment with concomitant radiotherapy/chemotherapy. CONCLUSIONS This is a hypothesis-generator study; thus, the recommendation is made to conduct randomized prospective studies to procure better knowledge on the impact of bilateral pelvic and para-aortic lymphadenectomy on this group of patients.
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Affiliation(s)
- Salim Abraham Barquet-Muñoz
- Departamento de Ginecología Oncológica, Instituto Nacional de Cancerología (INCan), Av. San Fernando #22 Col. Sección XVI Del. Tlalpan, Ciudad de Mexico, CP 14080 Mexico
| | - Gabriel Jaime Rendón-Pereira
- Departamento de Ginecología Oncológica, Instituto de Cancerología de Las Américas (ICLA), Diagonal 75B No. 2A - 80/140, Medellin, Colombia
| | - Denise Acuña-González
- Departamento de Ginecología Oncológica, Instituto Nacional de Cancerología (INCan), Av. San Fernando #22 Col. Sección XVI Del. Tlalpan, Ciudad de Mexico, CP 14080 Mexico
| | - Monica Vanessa Heymann Peñate
- Departamento de Gineconcologia, Hospital Medico Quirurgico y Oncologia, del Instituto Salvadoreño del Seguro Social, Alameda Juan Pablo II, San Salvador, El Salvador
| | - Luis Alonso Herrera-Montalvo
- Dirección de Investigación, Instituto Nacional de Cancerología (INCan), Av. San Fernando #22 Col. Sección XVI Del. Tlalpan, Ciudad de Mexico, CP 14080 Mexico
| | - Lenny Nadia Gallardo-Alvarado
- Subdirección de Investigación Clínica, Instituto Nacional de Cancerología (INCan), Av. San Fernando #22 Col. Sección XVI Del. Tlalpan, Ciudad de Mexico, CP 14080 Mexico
| | - David Francisco Cantú-de León
- Departamento de Ginecología Oncológica, Subdirección de Investigación Clínica, Instituto Nacional de Cancerología (INCan), Av. San Fernando #22 Col. Sección XVI Del. Tlalpan, Ciudad de Mexico, CP 14080 Mexico
| | - René Pareja
- Clínica de Oncología ASTORGA, Calle 8 # 43 C 110, Medellin, Colombia
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Šćepanović M, de Castro V, Leguey T, Auger M, Lozano-Perez S, Pareja R. Microstructural stability of ODS Fe–14Cr (–2W–0.3Ti) steels after simultaneous triple irradiation. Nuclear Materials and Energy 2016. [DOI: 10.1016/j.nme.2016.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Echeverri L, López C, Rendón GJ, Ángel G, Pareja R. Traquelectomía radical laparoscópica en pacientes con cáncer de cuello uterino en estado IB1 en el Instituto de Cancerología - Las Américas, Medellín, Colombia. ACTA ACUST UNITED AC 2016. [DOI: 10.4067/s0717-75262016000100007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Carro G, Muñoz A, Monge M, Savoini B, Pareja R. Microstructural and mechanical characterization of Cu-0.8 wt.%Y. Fusion Engineering and Design 2015. [DOI: 10.1016/j.fusengdes.2015.06.113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Echeverri L, Rendón G, Pareja R, Echeverri F, Madariaga M, Ramirez P. Outpatient laparoscopic radical hysterectomy. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Rendón G, Echeverri L, Pareja R, Araujo M, Madariaga M, Lucchini S, Ramirez P. A comparative analysis in management of ovarian cancer between a major tertiary cancer center and non-oncologic institutions in Medellín, Colombia. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pareja R, Rendón G, Echeverri L, Lucchini S, Madariaga M, Araujo M, Ramirez P. Immediate radical trachelectomy versus neoadjuvant chemotherapy followed by radical trachelectomy for patients with stage IB1 cervical cancer with tumors 2cm or larger: A literature review and analysis of oncological and obstetrical outcomes. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bedoya AM, Tate DJ, Baena A, Córdoba CM, Borrero M, Pareja R, Rojas F, Patterson JR, Herrero R, Zea AH, Sanchez GI. Immunosuppression in cervical cancer with special reference to arginase activity. Gynecol Oncol 2014; 135:74-80. [PMID: 25084511 DOI: 10.1016/j.ygyno.2014.07.096] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 07/16/2014] [Accepted: 07/23/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Cervical cancer is characterized by an immunosuppressive microenvironment and a Th2-type cytokine profile. Expression of arginase (ASE), the enzyme that converts L-arginine into L-ornithine and urea, is stimulated by Th2-type cytokines. OBJECTIVE To assess the association of ASE activity and L-Arg metabolism products with cervical cancer. METHODS Sera of 87 and 41 women with histologically confirmed by colposcopy-directed biopsy SCC and CIN3 respectively and 79 with normal cytology or Low-Grade Squamous Intraepithelial Lesion (LSIL), were evaluated. Cytokines were measured using Milliplex Human cytokine/chemokine kit. Arginase (ASE) activity was determined using an enzymatic assay. Levels of L-arginine, L-ornithine, putrescine and spermine were determined by HPLC. RESULTS Significantly higher levels of ASE activity were observed in women with CIN3 (age-adjusted OR: 24.3; 95%CI: 3.82-155) and SCC (AOR: 9.8; 95%CI: 2.34-40.8). As expected, possibly due to high levels of ASE activity, higher levels of l-Arg were negatively associated with CIN3 (AOR: 0.03; 95%CI: 0.004-0.19) and SSC (AOR: 0.06; 95%CI: 0.02-0.24). Consistent with the role of ASE in the conversion of L-arginine to L-ornithine and polyamine production therefrom, women with cervical cancer had higher levels of spermine and putrescine. A correlation analysis revealed a significant albeit weak relationship between high levels of IL-10 and high levels of ASE (Pearson r=0.32, p-value=0.003) in women with cervical cancer. CONCLUSION This study indicates that ASE activity and L-Arg degradation mechanisms of immunosuppression are present in cervical cancer. The results foster research in the design of possible strategies to inhibit ASE activity for therapy of cervical cancer.
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Affiliation(s)
- Astrid M Bedoya
- Group Infection and Cancer, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia; School of Microbiology, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia
| | - David J Tate
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA70112, USA
| | - Armando Baena
- Group Infection and Cancer, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia
| | - Carlos M Córdoba
- Group Infection and Cancer, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia; Hospital San Vicente Fundación, Calle 54 No 51D-154, Medellín, Colombia; Department of Gynecology and Obstetrics, School of Medicine, Universidad de Antioquia, UdeA, Calle 70 No 52-52, Medellin, Colombia
| | - Mauricio Borrero
- Group Infection and Cancer, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia; Department of Gynecology and Obstetrics, School of Medicine, Universidad de Antioquia, UdeA, Calle 70 No 52-52, Medellin, Colombia; Instituto de Cancerología Las Américas, Carrera 70 No 1-35, Torre 5, Medellín, Colombia
| | - René Pareja
- Instituto de Cancerología Las Américas, Carrera 70 No 1-35, Torre 5, Medellín, Colombia
| | - Fredy Rojas
- Instituto de Cancerología Las Américas, Carrera 70 No 1-35, Torre 5, Medellín, Colombia
| | - John R Patterson
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA70112, USA
| | - Rolando Herrero
- Prevention and Intervention Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon CEDEX 08, France
| | - Arnold H Zea
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA70112, USA.
| | - Gloria I Sanchez
- Group Infection and Cancer, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia.
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Pareja R, Rendon G, Angel G, Echeverri L, Ramirez P. Retrospective Analysis of 10 Consecutive Cases of Laparoscopic Radical Trachelectomy in Early Cervical Cancer. First American Experience. J Minim Invasive Gynecol 2013. [DOI: 10.1016/j.jmig.2013.08.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Martínez J, Savoini B, Monge M, Muñoz A, Armstrong D, Pareja R. Thermal stability of the grain structure in the W-2V and W-2V-0.5Y2O3 alloys produced by hot isostatic pressing. Fusion Engineering and Design 2013. [DOI: 10.1016/j.fusengdes.2013.05.057] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Parente P, Savoini B, Ferrari B, Monge M, Pareja R, Sanchez-Herencia A. Effect of highly dispersed yttria addition on thermal stability of hydroxyapatite. Materials Science and Engineering: C 2013; 33:864-9. [DOI: 10.1016/j.msec.2012.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 09/28/2012] [Accepted: 11/08/2012] [Indexed: 11/25/2022]
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Muñoz A, Monge M, Pareja R, Hernández M, Jimenez-Rey D, Román R, González M, García-Cortés I, Perlado M, Ibarra A. The materials production and processing facility at the Spanish National Centre for fusion technologies (TechnoFusión). Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2011.04.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Martínez J, Savoini B, Monge M, Muñoz A, Pareja R. Development of oxide dispersion strengthened W alloys produced by hot isostatic pressing. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2011.01.134] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Smith AL, Pareja R, Ramirez PT. Robotic radical hysterectomy. A literature review. Minerva Ginecol 2009; 61:339-346. [PMID: 19745798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Advanced laparoscopic procedures are increasingly being used as an alternative to laparotomy in gynecologic surgery. Several reviews have been completed that examine the advantages and drawbacks of this technique. Robotic technology offers the promise of overcoming many of the shortcomings of laparoscopy, while preserving classic operative techniques. This review article summarizes some of the most recent literature provided in the arena of robotic assisted radical hysterectomy for the treatment of cervical or endometrial cancer.
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Affiliation(s)
- A L Smith
- Department of Obstetrics and Gynecology, Geisinger Medical Center, Danville, PA, USA
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Ramirez P, Soliman P, Pareja R, Schmeler K. Macroscopic Para-Aortic Metastasis in Locally Advanced Cervical Cancer with Negative Imaging. J Minim Invasive Gynecol 2008. [DOI: 10.1016/j.jmig.2008.09.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Monge MA, Díaz JA, Pareja R. Strain-Induced Changes of Free Volume Measured by Positron Lifetime Spectroscopy in Ultrahigh Molecular Weight Polyethylene. Macromolecules 2004. [DOI: 10.1021/ma049103i] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. A. Monge
- Departamento de Física, Universidad Carlos III de Madrid, 28911 Leganés, Spain
| | - J. A. Díaz
- Departamento de Física, Universidad Carlos III de Madrid, 28911 Leganés, Spain
| | - R. Pareja
- Departamento de Física, Universidad Carlos III de Madrid, 28911 Leganés, Spain
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Pareja R. The measure, the problem: communication at work in Ecuador. Dev Commun Rep 2002:7. [PMID: 12339976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Monge MA, Villaluenga JPG, Muñoz A, Leguey T, Pareja R. Annealing-Induced Enhancement of the Gas Diffusivity in Coextruded LLDPE Films Investigated by Positron Lifetime Spectroscopy. Macromolecules 2002. [DOI: 10.1021/ma020484e] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. A. Monge
- Departamento de Física, Universidad Carlos III de Madrid, 28911 Leganés, Spain, and Departamento de Física Aplicada I, Facultad de Ciencias Físicas, Universidad Complutense, 28040 Madrid, Spain
| | - J. P. G. Villaluenga
- Departamento de Física, Universidad Carlos III de Madrid, 28911 Leganés, Spain, and Departamento de Física Aplicada I, Facultad de Ciencias Físicas, Universidad Complutense, 28040 Madrid, Spain
| | - A. Muñoz
- Departamento de Física, Universidad Carlos III de Madrid, 28911 Leganés, Spain, and Departamento de Física Aplicada I, Facultad de Ciencias Físicas, Universidad Complutense, 28040 Madrid, Spain
| | - T. Leguey
- Departamento de Física, Universidad Carlos III de Madrid, 28911 Leganés, Spain, and Departamento de Física Aplicada I, Facultad de Ciencias Físicas, Universidad Complutense, 28040 Madrid, Spain
| | - R. Pareja
- Departamento de Física, Universidad Carlos III de Madrid, 28911 Leganés, Spain, and Departamento de Física Aplicada I, Facultad de Ciencias Físicas, Universidad Complutense, 28040 Madrid, Spain
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Levine WC, Revollo R, Kaune V, Vega J, Tinajeros F, Garnica M, Estenssoro M, Lewis JS, Higueras G, Zurita R, Wright-De Agüero L, Pareja R, Miranda P, Ransom RL, Zaidi AA, Melgar ML, Kuritsky JN. Decline in sexually transmitted disease prevalence in female Bolivian sex workers: impact of an HIV prevention project. AIDS 1998; 12:1899-906. [PMID: 9792391 DOI: 10.1097/00002030-199814000-00022] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To implement an HIV prevention intervention among female commercial sex workers (CSW), and to monitor key outcomes using routinely collected clinical and laboratory data. DESIGN Cross-sectional and longitudinal analysis of data from an open-enrollment cohort. SETTING One public sexually transmitted disease (STD) clinic and about 25 brothels in La Paz, Bolivia. PARTICIPANTS A total of 508 female CSW who work at brothels and attend a public STD clinic. INTERVENTION Improved STD clinical care, supported by periodic laboratory testing, and behavioral interventions performed by a local non-governmental organization. MAIN OUTCOME MEASURES Prevalence of gonorrhea, syphilis (reactive plasma reagin titer > or = 1 : 16), genital ulcer disease, chlamydial infection, and trichomoniasis; self-reported condom use in the previous month; and HIV seroprevalence. RESULTS From 1992 through 1995, prevalence of gonorrhea among CSW declined from 25.8 to 9.9% (P < 0.001), syphilis from 14.9 to 8.7% (P = 0.02), and genital ulcer disease from 5.7 to 1.3% (P = 0.006); trends in prevalence of chlamydial infection and trichomoniasis were not significant. Self-reported condom use during vaginal sex in the past month increased from 36.3 to 72.5% (P < 0.001). In a multivariate analysis, condom use was inversely associated with gonorrhea [odds ratio (OR), 0.63; 95% confidence interval (Cl), 0.41-0.97], syphilis (OR, 0.39; 95% Cl, 0.23-0.64), and trichomoniasis (OR, 0.44; 95% Cl, 0.32-0.71). In 1995, HIV seroprevalence among CSW was 0.1%. CONCLUSION Effective prevention interventions for female CSW can be implemented through public services and non-governmental organizations while HIV rates are still low, and key outcomes can be monitored using data obtained from periodic screening examinations.
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Affiliation(s)
- W C Levine
- Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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Monge MA, Pareja R, González R, Chen Y. Positron bound states on hydride ions in thermochemically reduced MgO single crystals. Phys Rev B Condens Matter 1996; 54:8950-8953. [PMID: 9984604 DOI: 10.1103/physrevb.54.8950] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Pareja R, Marí B, Segura A, Muñoz V. Thermal recovery of the lattice damage in neutron-transmutation-doped InSe. Phys Rev B Condens Matter 1993; 47:2870-2873. [PMID: 10006349 DOI: 10.1103/physrevb.47.2870] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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González R, Pareja R, Chen Y. Protons in neutron-irradiated and thermochemically reduced MgO crystals doped with lithium impurities. Phys Rev B Condens Matter 1992; 45:12730-12735. [PMID: 10001329 DOI: 10.1103/physrevb.45.12730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Pareja R, González R, Boatner LA, Chen Y. Effect of thermochemical reduction on the electrical, optical-absorption, and positron-annihilation characteristics of ZnO crystals. Phys Rev B Condens Matter 1992; 45:6581-6586. [PMID: 10000417 DOI: 10.1103/physrevb.45.6581] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Pareja R, Pedrosa MA, González R, Chen Y. Positronium hydride in hydrogen-laden thermochemically reduced MgO single crystals. Phys Rev B Condens Matter 1990; 41:6220-6226. [PMID: 9992866 DOI: 10.1103/physrevb.41.6220] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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García-Cabaes A, Sanz-García JA, Cabrera JM, Agulló-López F, Zaldo C, Pareja R, Polgár K, Raksányi K, Fölvàri I. Influence of stoichiometry on defect-related phenomena in LiNbO3. Phys Rev B Condens Matter 1988; 37:6085-6091. [PMID: 9943839 DOI: 10.1103/physrevb.37.6085] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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Riveiro JM, Pareja R. Evidence for a reversible structural transformation in the metallic glass Co58Ni10Fe5B16 Si11. Phys Rev B Condens Matter 1986; 34:2029-2031. [PMID: 9939879 DOI: 10.1103/physrevb.34.2029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Lynn KG, Chen DM, Nielsen B, Pareja R, Myers S. Variable-energy positron-beam studies of Ni implanted with He. Phys Rev B Condens Matter 1986; 34:1449-1458. [PMID: 9939790 DOI: 10.1103/physrevb.34.1449] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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Díaz L, Pareja R, Pedrosa MA, González R. Positron annihilation and electron microscopy study in the early stage of fatigue of polycrystalline copper. ACTA ACUST UNITED AC 1985. [DOI: 10.1002/pssa.2210920114] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Chen DM, Lynn KG, Pareja R, Nielsen B. Measurement of positron reemission from thin single-crystal W(100) films. Phys Rev B Condens Matter 1985; 31:4123-4130. [PMID: 9936337 DOI: 10.1103/physrevb.31.4123] [Citation(s) in RCA: 63] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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Brace J, Pareja R. Mass media in Peru promotes "responsible parenthood". Dev Commun Rep 1985:7, 10. [PMID: 12313874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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